Efficacy of mepolizumab treatment in patients with chronic rhinosinusitis with nasal polyps: a single-centre, real-life study

Introduction:
The anti-interleukin (IL)-5 antibody mepolizumab has been used in the treatment of patients with uncontrolled severe eosinophilic asthma.

Aim:
In this real-life study, we aimed to evaluate the effect of mepolizumab on nasal symptoms in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).

Material and methods:
Adult patients (> 18 years old) with concomitant CRSwNP, who were treated with mepolizumab at a dose of 100 mg every 4 weeks for at least one year for severe eosinophilic asthma, between 2021 and 2022, were evaluated retrospectively. Asthma control testing (ACT), Sino-Nasal Outcome Test (SNOT-22), and a visual analogue scale (VAS) of 1 to 10 (from 1 to 10) for nasal symptoms were compared at baseline (pre-mepolizumab treatment), and at 6 and 12 months post-treatment. The need for endoscopic sinus surgery (ESS) and oral corticosteroid (OCS) was compared at 12 months pre-mepolizumab and post-mepolizumab treatment.

Results:
The mean age of the 18 patients (9 (50%) males and 9 (50%) females) was 42.33 ±15.9 years. Mepolizumab significantly reduced the number of endoscopic sinus surgeries (ESSs) (p = 0.002). The need for short-course oral corticosteroid (OCS) decreased significantly after mepolizumab treatment (p = 0.029). Statistically significant improvements were found in the ACT, SNOT-22, and nasal symptom scores at 6 and 12 months post-treatment when compared to baseline. No side effects were observed post-treatment.

Conclusions:
Mepolizumab improved nasal symptoms and reduced the need for OCS and ESS in patients with CRSwNP. However, the results obtained in the study should be confirmed with real-life studies involving larger numbers of patients.